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Table 1 Overview of intervention content and delivery schedule

From: Disentangling the effects of a multiple behaviour change intervention for diarrhoea control in Zambia: a theory-based process evaluation

Component

Target Audience

Setting

Implementers

Content

Delivery

Radio adverts & Call-in Show

Population in target areas, particularly caregivers of children under-five

Broadcast on 3 radio stations: Komboni Radio, Radio 1 and Radio 4

Komboni Housewives and Radio Master of Ceremonies (MCs)

Airing of three different spot adverts (EBF, HWWS, ORS + Zinc); similar content to that described in the forum & road shows skits. Call-in shows used as a discussion forum and to amplify the activities of the women’s forums (the timing of the shows coincided with the women’s forums). Discussions scripted around the target behaviours to test the callers' understanding of the intervention messages. Jingle about the target behaviours also played.

3 times a week for 6 months, with penetration in both intervention and control areas.

Komboni Housewives Women’s Forums

~20 caregivers of children under-five

Forums held in the community at the home of a host (an intervention recipient)

Komboni Housewives

All four behaviours targeted using: 1) skits (feature the Komboni Housewives gossiping about mothers they believe are not practicing the correct behaviours, being proven wrong and welcoming the mother into their group); 2) discussion with question and answer sessions; 3) emotionally engaging demonstrations (designed to evoke feelings of disgust at mixed feeding a baby under six months and not handwashing with soap, and nurture in relation to incorrect preparation of ORS); and 4) short films featuring the Komboni Housewives (introduced partway through the intervention period). Activities were supported by banners, certificates, stickers, a branded bus and prizes (hats and T-shirts).

One or two forums a day throughout intervention period; rotating between the eight intervention areas.

ORT Corner "Circle of mothers" sessions (with monthly prize draw)

Caregivers of children under five (preferentially those with a child presenting with diarrhoea)

At the ORT corner (where ORS solution is traditionally available) or another designated area in the government clinic in each intervention area

Two Neighbourhood Health Committee Volunteers (NHCs) linked to the clinic in each site

Circle of Mothers: content similar to forums designed to be shorter and focussed on exclusive breastfeeding and ORS and zinc.

Every Monday-Friday at clinics in all 8 sites.

Prize draws: Winner of a hamper selected from all caregivers who attended the clinic session in the previous month. The Komboni Housewives conducted a mini forum at select prize draws.

Monthly in each site. Attended by Komboni Housewives once per site.

Road shows

All community members

Large public space in each site

MCs and Komboni Housewives (featuring a well-known local musician, Afunika)

Large road shows, one in each intervention area. Similar content to the forums but energised by the presence of the MCs and the presence of Afunika who sang the campaign song and engaged the audience in discussion about the target behaviours. CDs featuring the campaign song as well as hat and T-shirts were given to those giving correct answers in a quiz.

One road show in each site.

  1. MC Master of Ceremonies, EBF exclusive breastfeeding, HWWS handwashing with soap, ORS oral rehydration salts, ORT Oral rehydration therapy